|Número de publicación||US8313491 B2|
|Tipo de publicación||Concesión|
|Número de solicitud||US 12/544,279|
|Fecha de publicación||20 Nov 2012|
|Fecha de presentación||20 Ago 2009|
|Fecha de prioridad||20 Ago 2009|
|También publicado como||US8523870, US8828015, US20110046629, US20130046309, US20130304071|
|Número de publicación||12544279, 544279, US 8313491 B2, US 8313491B2, US-B2-8313491, US8313491 B2, US8313491B2|
|Inventores||Michael Green II John, David Bradford Harness|
|Cesionario original||Wright Medical Technology, Inc.|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (18), Citada por (55), Clasificaciones (5), Eventos legales (4)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
The present disclosure is related to bone chamfer resection guides use for performing chamfer or bevel resections at the distal end of a femur in connection with distal femoral total knee implant surgery.
Chamfer resection guides are used in orthopedic surgery for resecting the distal end of the femur. Currently available chamfer resection guides are monolithic instruments and are secured to a distal femoral resection by means of either pins or orthogonal flange protruding from the distal face of the instrument. Once the instrument is coupled to the distal femur and its position is established, adjustment of the instrument requires that the chamfer resection guide is removed and its reference features are repositioned by some other means. These features typically are either holes in the distal femur, or a rough anterior resection.
Other devices used to refine the final position of he chamfer resection guide and subsequently the implant are used in steps either prior to choosing the best size chamfer resection guide (a step known as sizing the femur) using a femoral caliper or by removing the chamfer resection guide altogether and using another device to relocate the referencing features that the chamfer guide was attached to.
A chamfer resection guide is the best instrument for checking the final position of the resections before making the resections. This is because the resections are made through the guide, so a reference plane (i.e. a bladerunner) can be placed through the guide to re-check the resection levels. Instruments that attempt to refine the final position of the chamfer guide without the guide in place does not provide the user an accurate means of verifying the resection levels of the final implant. Additionally, if the chamfer resection guide does need to be repositioned, removal of the guide and adjustments of its referencing features takes additional time and induces a chance for additional error.
According to an embodiment of the present disclosure a chamfer resection guide assembly for a distal total knee implant is disclosed. The chamfer resection guide assembly comprises an anchor member for attaching to a resected distal surface of a femur, a block member including one or more cutting guide slots and a femoral contacting surface for placement against the resected distal surface of the femur, and a camming member. The femoral contacting surface of the block member is provided with a recessed region in which the anchor member is slidably engaged therein. The camming member operably connects the block member and the anchor member and is configured for linearly displacing the anchor member and the block member with respect to each other for adjusting the position of the block member with respect to the femur when the anchor member is attached to the distal resection of the femur.
The chamfer resection guide assembly of the present disclosure is configured so that the position of the chamfer resection guide attached to the distal end of a femur can be adjusted without removing the chamfer resection guide assembly from the distal end of the femur.
The features shown in the above referenced drawings are illustrated schematically and are not intended to be drawn to scale nor are they intended to be shown in precise positional relationship. Like reference numbers indicate like elements.
This description of the exemplary embodiments is intended to be read in connection with the accompanying drawings, which are to be considered part of the entire written description. In the description, relative terms such as “lower,” “upper,” “horizontal,” “vertical,”, “above,” “below,” “up,” “down,” “top” and “bottom” as well as derivative thereof (e.g., “horizontally,” “downwardly,” “upwardly,” etc.) should be construed to refer to the orientation as then described or as shown in the drawing under discussion. These relative terms are for convenience of description and do not require that the apparatus be constructed or operated in a particular orientation. Terms concerning attachments, such as “coupled”, “connected” and “interconnected,” refer to a relationship wherein structures are secured or attached to one another either directly or indirectly through intervening structures, as well as both movable or rigid attachments or relationships, unless expressly described otherwise.
The block member 1 has two major sides: a top side 30, the side that faces away from the femoral bone when in use, and a femoral contacting surface 32 side. The side that faces the femur and has femoral contacting surfaces 32 is attached to the distal resected surface of the femur during use. Provided on the femoral contacting surface 32 of the block member 1 is a recessed region 40 in which the anchor member is slidably engaged therein. The recessed region 40 is cut into the femoral contacting surface 32 and is defined by a pair of guiderail structures 12 for engaging the anchor member 5. The guiderail structures 12 extend parallel to the longitudinal axis L of the chamfer resection guide assembly 100. Thus, the recessed region 40 extends along the longitudinal axis L and allows the anchor member 5 to slide linearly within the recessed region 40 parallel to the longitudinal axis L. To guiderail structures 12 and the anchor member 5 are configured to slidably engage each other while preventing the anchor member 5 from moving in lateral directions (i.e. perpendicular to the longitudinal axis L). For example, in the illustrated embodiment, the guiderail structures 12 are configured to have an undercut profile while the anchor member 5 is provided with corresponding male boss structures 13 along the sides that engage the guiderail structures 12. These engaging structures are shown in detail in the cross-sectional view in
When assembled and situated within the recessed region 40 of the block member 1, the side of the anchor member 5 that faces in the same direction as the femoral contacting surface 32 will be referred to herein as the second femoral contacting surface 35. The anchor member 5 may be provided with an appropriate means for attaching or anchoring to the resected distal surface of the femur. In the illustrated example, two anchoring pins 8 are provided on the second femoral contacting surface 35 of the anchor member 5. The anchoring pins 8 can be inserted into predrilled holes in the femur to attach the anchor member 5 and, thus, the chamfer resection guide assembly 100 to the resected distal surface of the femur.
In the longitudinal cross-sectional view of a fully assembled chamfer resection guiding assembly 100 shown in
The adjustment plunger 2 has a first end 60 and a second end 61. The first end 60 of the adjustment plunger 2 is configured for being received into a first blind hole 45 provided in the recessed region 40 and cooperating with the block member 1. The adjustment plunger 2 and the cam body 4 are configured to couple together to rotate about the longitudinal axis LL of the camming member 20 in unison while translating axially with respect to each other. This coupling configuration is achieved by a motise and tenon joint. In the illustrated example, a tenon 9 structure is provided at the second end 61 of the adjustment plunger 2 that mates with a corresponding mortise 10 structure provided in the cam body 4. The mortise and tenon joint transfer rotational loads from the adjustment plunger 2 to the cam body 4 thus allowing them to rotate together while permitting the adjustment plunger 2 to translate axially when the adjustment plunger 2 is pushed towards the cam body 4. It would be equally effective to swap the locations of the mortise 10 and the tenon 9 structures shown in the illustrated example. Alternatively, other functionally equivalent structures can be provided on the cam body 4 and the adjustment plunger 2 to form the coupling.
The anchor member 5 is slid into the recessed region 40 of the block member 1 using the guiderail structures 12 as the guide while compressing the camming member 20 assembly into the first blind hole 45. The guiderail structures 12 of the block member 1 engages the male boss structures 13 of the anchor member 5 as discussed above.
The anchor member 5 is provided with a tab portion 55 that extend longitudinally for engaging the block member 1. The block member 1 is provided with a complementary slot 51 for receiving the tab portion 55. In the fully assembled state shown in
The cam body 4 comprises an offset cylinder boss 15 that fits into and engages the blind slot 14 of the anchor member 5. This arrangement allows the chamfer resection guide assembly 100 to be held together as the offset cylinder boss 15 is always urged into the blind slot 14 of the anchor member 5 by the force of the coil spring 3. A through hole 16 may be provided in the anchor member 5 permitting access to the cam body 4 and allowing disassembly of the chamfer resection guide assembly 100. By depressing the cam body 4 through the through hole 16 compressing the coil spring 3, the offset cylinder boss 15 is removed from the blind slot 14 and the anchor member 5 can be removed from the block member 1 for disassembly.
As shown in
As shown in
When the anchor member 5 is attached to the distal femoral resection, the position of the anchor member 5 with respect to the femoral bone will be fixed and the position of the block member 1 with respect to the femoral bone can be adjusted by using the camming member 20. The adjustment plunger 2 and the first blind hole 45 of the block member 1 are configured to allow controlled adjustment of the relative position of the block member 1 with respect to the anchor member 5. In the illustrated example chamfer resection guide assembly 100, the adjustment plunger 2 is configured to have a mid-section 62 that is larger in diameter than the first end 60 and the second end 61, as shown in
As shown in
To adjust the position of the block member 1 with respect to the anchor member 5, the adjustment plunger 2 is pushed inward (i.e. away from the retaining lip 46 and towards the femoral contact surface 32) along its longitudinal axis LL compressing the coil spring 3. This disengages the first end 60 of the adjustment plunger 2 from the retaining lip 46 of the first blind hole 45 and unlocks the adjustment plunger 2 allowing it to be turned. In the illustrated example, the chamfer resection guide assembly 100 is configured to have three adjustment positions for the block member 1 using the hexagonal shape of the adjustment plunger 2 and the retaining lip 46 of the first blind hole 45.
As discussed above, turning the adjustment plunger 2 results in the camming action of the offset cylinder boss 15, thus, sliding the block member 1 in one of the two directions noted by the arrow A in
The camming action provided by the rotation of the camming member 20 about its rotational axis, the longitudinal axis LL, is shown in
The first end 60 of the adjustment plunger 2 is preferably configured for receiving an adjustment tool, such as a screw driver or a wrench, that is used for pressing and turning the adjustment plunger 2. As shown in
The camming member operatively connects the block member and the anchor member and is configured for linearly displacing the anchor member and the block member with respect to each other for adjusting the position of the anchor member within the recessed region of the block member.
When the chamfer resection guide assembly 100 is attached to the distal end of a femur the anchor member 5 is sandwiched between the resected surface of the femoral bone and the block member 1. Thus, if the position of one or more of the guiding slots 6 is such that the anchor member 5 blocks one or more of the guiding slots 6, the anchor member may be provided with appropriate number of clearance cutouts 7 for allowing the saw blade of the cutting tool to extend through the anchor member 5 when resections are being made through the guiding slots 6. For example, in the illustrated embodiment, the clearance cutouts 7 provide clearance for the guiding slots 6 a.
The chamfer resection guide assembly 200 contacts the resected distal surface 310 of the femur 300 so that the second femoral contacting surface 35 of the anchor member 5 a is flush against the resected distal surface 310 of the femur 300. With the second femoral contacting surface 35 contacting the resected distal surface 310 of the femur 300, the chamfer resection guide 200 is positioned to have the footplate extension 8 a come in contact with the resected anterior surface 320 of the femur 300. This allows anterior referencing of the chamfer cuts effected with the chamfer resection guide assembly 200 because the positions of the chamfer guiding slots 6 are referenced against the resected anterior surface 320.
Unlike the existing resection guides that require repositioning of multiple instruments to adjust the position of the instrument in the anterior/posterior direction, the position of the chamfer resection guide of the present disclosure can be adjusted in the anterior/posterior direction without removing and repositioning the instrument. Thus, the chamfer resection guide of the present disclosure saves time and reduce potential error by leaving the appropriately chosen size chamfer resection guide in position and refining its final position through a mechanism that is conducive to a minimally invasive procedure. Other adjustment resection guides of a similar nature have large knobs that could interfere with soft tissue. The adjustment mechanism of the chamfer resection guide of the present disclosure is self-contained within the chamfer resection guide and also simultaneously functions to hold the assembly of the instrument together. Thus, the chamfer resection guide can be assembled without additional assembly processes such as crosspinning, welding, etc. This feature allows the assembly process for the instrument to be simpler and less costly.
Although the invention has been described in terms of exemplary embodiments, it is not limited thereto. Rather, the appended claims should be construed broadly, to include other variants and embodiments of the invention, which may be made by those skilled in the art without departing from the scope and range of equivalents of the invention. The scope of the invention disclosed herein is to be limited only by the following claims.
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|Clasificación de EE.UU.||606/88, 606/87|
|9 Oct 2009||AS||Assignment|
Owner name: WRIGHT MEDICAL TECHNOLOGY, INC., TENNESSEE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:GREEN, JOHN MICHAEL, II;HARNESS, DAVID BRADFORD;REEL/FRAME:023358/0197
Effective date: 20090901
|10 Ene 2014||AS||Assignment|
Owner name: OTSUKA MEDICAL DEVICES CO., LTD., JAPAN
Free format text: PATENT SECURITY AGREEMENT SUPPLEMENT;ASSIGNOR:MICROPORT ORTHOPEDICS HOLDINGS INC.;REEL/FRAME:031968/0377
Effective date: 20140108
|7 Mar 2014||AS||Assignment|
Owner name: MICROPORT ORTHOPEDICS HOLDINGS INC., NETHERLANDS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:WRIGHT MEDICAL TECHNOLOGY, INC.;REEL/FRAME:032410/0254
Effective date: 20140106
|5 May 2016||FPAY||Fee payment|
Year of fee payment: 4